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Heterotopic caesarean scar pregnancy with spontaneous conception
Jennifer Townsend1, Kai Kwan Chiu2, Louise Carew2
1Obstetrics and Gynaecology, West Hertfordshire Teaching Hospitals NHS Trust, Watford, UK jennifer.townsend1@nhs.net.
BMJ Case Reports
|August 7, 2026
Summary
A rare heterotopic caesarean scar pregnancy, where both intrauterine and scar pregnancies were viable, was successfully managed surgically. This case highlights the need for research into managing this condition, which is increasing due to rising C-section rates.
Area of Science:
- Reproductive Medicine
- Obstetrics & Gynecology
Background:
- Heterotopic pregnancies, where both an intrauterine and an ectopic pregnancy coexist, are uncommon.
- Caesarean scar pregnancies, a specific type of ectopic pregnancy within a prior C-section scar, are rare but increasingly reported.
- Concurrent viable intrauterine and caesarean scar pregnancies represent an exceptionally rare scenario.
Purpose of the Study:
- To present a case of a rare heterotopic caesarean scar pregnancy with a coexisting viable intrauterine pregnancy.
- To detail the successful surgical management of this complex pregnancy.
- To emphasize the need for further research and guidelines due to increasing incidence.
Main Methods:
- A detailed case report of a patient in her early 30s with spontaneous conception.
- Surgical intervention for the management of the heterotopic caesarean scar pregnancy.
- Review of limited existing literature on diagnosis, management, and outcomes.
Main Results:
- The patient presented with a viable intrauterine pregnancy and a viable heterotopic caesarean scar pregnancy.
- Successful surgical management of the heterotopic caesarean scar pregnancy was achieved.
- The case underscores the diagnostic and therapeutic challenges associated with this rare condition.
Conclusions:
- Heterotopic caesarean scar pregnancy is a rare but significant clinical entity.
- Successful surgical management is feasible, but requires careful consideration.
- Increased rates of caesarean sections and assisted reproductive technologies necessitate further research for established management guidelines.
